title: Hospital costs associated with depression in a cohort of older men living in Western Australia.
abstract: BACKGROUND
  There is lack of information of the hospital costs related to depression. Here, we compare the costs associated with general hospital admissions over 2 years between older men with and without a documented past history of depression.
  
  
  METHODS
  A community-based cohort of older men living in Perth, Western Australia, was assessed at baseline between 2001 and 2004 and followed up for 2 years by prospective data linkage. The participants were selected randomly from the Australia electoral roll. Two-year hospital costs were estimated.
  
  
  RESULTS
  Among 5411 patients, 75% of 339 men with depressive symptoms had at least one hospital admission compared with 61% of 5072 men without depression (P<.001). Two-year median hospital costs in the depressed group were A$4153 compared with A$1671 in participants free from depression (P<.001). In multivariate analysis, the presence of clinically significant depressive symptoms remained an independent predictor of higher cost [incident rate ratios (RR)=1.44, 95% confidence interval (CI): 1.23-1.68] and was associated with being a high-cost user of health services (RR=2.04, 95% CI: 1.43-2.92).
  
  
  CONCLUSIONS
  The estimation of costs was solely based on the main diagnosis, potentially leading to underestimates of the real cost differences.
  
  
  CONCLUSIONS
  Hospital care cost was higher for older men with documented evidence of past depression than those without. The issue of depression in later life must be tackled if we want to optimize the use of limited hospital resources available.
authors.affiliation: Department of Public Health & Primary Care, Institute of Public Health, Cambridge University, UK; Western Australia Centre for Health & Ageing, Centre for Medical Research, University of Western Australia; Centre for Global Mental Health, Institute of Psychiatry at King's College London, London, UK. Electronic address: matthew.prina@kcl.ac.uk.
authors.forename: A Matthew
authors.initials: AM
authors.lastname: Prina
authors.affiliation: Department of Epidemiology & Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Sociology, VU University, Amsterdam, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Huisman
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia; Department of Endocrinology and Diabetes, Fremantle Hospital, Western Australia.
authors.forename: Bu B
authors.initials: BB
authors.lastname: Yeap
authors.affiliation: Western Australia Centre for Health & Ageing, Centre for Medical Research, University of Western Australia; Department of Neurology, Royal Perth Hospital, Perth, Australia.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.affiliation: Western Australia Centre for Health & Ageing, Centre for Medical Research, University of Western Australia; School of Medicine and Pharmacology, University of Western Australia; Department of Geriatric Medicine, Royal Perth Hospital.
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.affiliation: Department of Public Health & Primary Care, Institute of Public Health, Cambridge University, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.affiliation: Western Australia Centre for Health & Ageing, Centre for Medical Research, University of Western Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia; Department of Psychiatry, Royal Perth Hospital.
authors.forename: Osvaldo P
authors.initials: OP
authors.lastname: Almeida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D003863:Depression / Q000191:economics*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D014904:Western Australia
keywords: Cost; Depression; Geriatric psychiatry; Western Australia